Trabecular Psammomatoid, Trabecular form Seen in younger patients. Mean age is approximately 11 years, Psammomatoid form Appears outside of the jaws 70% arising in the orbital and frontal bones and paranasal sinuses. Psammomatoid form Abundant cellular fibrous connective tissue in a whorled pattern    Proliferating fibroblasts form spicules of bone and Cementum  at maturity the bone may be somewhat normal, Areas of hemorrhage and small clusters of multinucleated giant cells.Trabecular variant shows irregular strands of highly cellular osteoid encasing plump and irregular osteocytes. The psammomatoid pattern forms concentric lamellated and spherical ossicles that vary in shape and typically have basophilic centers with peripheral eosinophilic osteoid rims

1. JUVENILE OSSIFYING FIBROMA
DR AMITHA G, BDS, MDS
ORAL AND MAXILLOFACIAL PATHOLOGY

2. JUVENILE OSSIFYING FIBROMA:
TWO PATTERNS
(1) Trabecular
(2) Psammomatoid,
Trabecular form
• Seen in younger patients.
• Mean age is approximately 11 years,
Psammomatoid form
• Appears outside of the jaws
• 70% arising in the orbital and frontal bones and paranasal sinuses.

4. Clinical Features
• Early to late childhood
• Maxilla > Mandible
• Singular, slow-growing, painless swelling
• Overgrowth of tissue that occurs centrally in the jaws
• May involve impacted or unerupted teeth disfiguring
• Increased level of serum alkaline phosphatase
• Severe maloccusion
Aggressive form:
• Symptomatic if traumatized
• Ulcerated
• Maxilla lesion may interfere with sight and breathing

6. Histologic Features:
Psammomatoid form
• Abundant cellular fibrous connective tissue
in a whorled pattern
• Proliferating fibroblasts form spicules of
bone and
• Cementum at maturity the bone may be
somewhat normal,
• Areas of hemorrhage and small clusters of
multinucleated giant cells,

7. Trabecular variant
shows irregular strands of highly cellular
osteoid encasing plump and irregular
osteocytes.
•The psammomatoid pattern forms
concentric lamellated and spherical ossicles
that vary in shape and typically have
basophilic centers with peripheral
eosinophilic osteoid rims

8. RADIOGRAPHIC FEATURES:
• Radiolucent or mixed radiolucent and radiopaque appearance (ground glass),
• Lamina dura is usually obscured and the cortical plates thinned

9. TREATMENT AND PROGNOSIS:
• Management and prognosis are uncertain.
• Smaller lesions, complete local excision or thorough curettage appears adequate,
• Rapidly growing lesions, wider resection may be required
• Recurrence rates of 30% to 58%
• Malignant transformation has not been documented.

10. THANK YOU